Petersel, Kenneth H

Petersel, Kenneth H is an individual health care provider with primary practice located at 1617 Front St , East Meadow NY 11554-2345. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Petersel, Kenneth H can be contacted via phone (516) 794-1330.

Contact Information

Primary practice address
1617 Front St East Meadow NY 11554-2345
Phone: (516) 794-1330
Fax: (516) 794-1531
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 137623 New York

Profile Details

NPI number 1023085917
LBN Legal business name Petersel, Kenneth H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023085917 NPPES
New York MEDICAID 00659389

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